CAMP PROFORMA
APEENDIX ‘A’
WILLINGNESS CERTIFICATE
I-------------------------------------------------------------------------SD/JD Cadet Rank--------------------------------------------------------
Regtl No.-----------------------------------------------------------------------------------------------------------------------------------------------
College/School, am willing to proceed for the------------------------------------------------------------------------------------------------
to be held in the month ------------------------------------from--------------------------------to------------------------------------------------
My exams are over therefore, I may be allowed to attend the camp.
Signature----------------------------
Name---------------------------------
(in block letters)
Address-------------------------------
APPENDIX ‘B’
MEDICAL FITNESS CERTIFICATE
Certified that I have examined No----------------------------------------------------Rank---------------------------------
Name -------------------------------------------------------of College/School----------------------------------------------------------------
Unit-----------------------------------------------------------------in accordance with the standard laid down in NCC Act and Rules
Appendix ‘A’ and found him fit to undergo training of--------------------------------------------------------------------------
with-------------------------------------------------------------------------------------------which is of sternous Nature and to be held at
--------------------------------------------------------from-------------------------------------------------to------------------------------------------
I also certify that the Officer/Cadet has been inoculated against TAB and small Pox.
Date----------------- Signature of Medical Officer
Name in Block Letters
Rank-------------------------Designation------------------------------
COUNTER SIGNATURE OF OC UNIT
APPENDIX ‘C’
RISK CERTIFICATE
This is to certify that I No.-------------------------------------------------Rank------------------------------------------------------
Name-------------------------------------------of College/School-------------------------------Unit---------------------------------------------
volunteer to attend ----------------------------------------------------------with-----------------------------------------------------------------
to be held at --------------------------------from--------------------------------------------to----------------------------------------at my risk.
Date-----------------------Place-------------------------- Signature of NCC Officer/cadet
Counter Signature of Cadet’s parent/guardian for cadets only) Signature of father/guardian
Name in block letters--------------------------------------------
Address-------------------------------------------------------------
Attested by the principal of College (Seal)
Date------------------------Place-------------------------
COUNTER SIGNATURE OF OC UNIT
APPENDIX ‘D’
SAFETY PRECAUTION CERTIFICATE
I know that there is deep sea water near the camp site and the area is OUT OF BOUNDS, If I go there, I will
be responsible.
S.No. Date School/College Name Number Signature
Certificates signed in my presence
Date--------------------Place---------------------- Signature of OC Unit--------------------------------
Rank & Name----------------------------------------
Appendix ‘B’
Annexure to Form I
INDEMNITY BOND (Application for enrolment)
To,
The President of India
In consideration of my being nominated either by the NCC authorities or at my own request as a
participant in any NCC camp (which includes Republic Day Camp and Independence Day Camp in Delhi),
Course, Adventure Training (including Army, Navy and Air Wing Activities, as the case may be) and while
travelling (in domestic/international surface, air and water transport) and attending Youth Exchange
Programmes abroad, I undertake and agree that neither I, nor my executors or administrators or other
legal representatives will make any claim against the Government or against NCC authorities including
Officers, JCOs/NCOs or their equivalents from Navy and Air Force, civilians, MT drivers or against any
other such person in the service of the Government, in respect of any loss or injury – to the property or
person, including injury resulting in death, due to any reasons whatsoever which I may suffer, while or in
consequence of my participation in the above activities and I understand that no compensation will be
paid by the Government or NCC authorities including officers, JCO’s/NCO’s or their equivalents from
Navy and Air Force or civilian MT drivers in respect of any such loss or injury and I agree as to bind
myself, my executors and administrators and other legal representatives to indemnify the Government or
NCC authorities including officers, JCO’s/NCO’s or their equivalents from Navy and Air Force or Civilian
MT drivers in the service of Government against any claim which may be from any third party against
them or any of them arising out of any act of default on my part during or in connection with the said
camps, courses, adventure training, travelling and while on Youth Exchange Programme or any other
such NCC activities as may be organised from time to time within or outside the Union of India.
Witness Signature of Applicant------------------------
No.-------------------------------------------------
(1) Signature----------------------------- Name----------------------------------------------
Name --------------------------------- Unit/Group---------------------------------------
Address ------------------------------
(2) Signature--------------------------- Signature of Parent/Guardian-------------------------
Name ------------------------------- Name --------------------------------------------------------
Address ---------------------------- Address -----------------------------------------------------
Date
Place
(Note : In case of SD applicant being a minor, Indemnity bond applicable to Minor will be used)
